Pardon Me? How to Enable Successful Communication with the Hearing Impaired

Today, Sci-Ed is happy to welcome Rachel Wayne to the blog for the first of three posts to discuss hearing impairment in higher education. For more about Rachel, see the end of this post.

Here are a few things you should know about me: I am a PhD student in clinical psychology. I enjoy writing, hiking, single malt whisky. I love to travel and listen to live music.

I’m also hard of hearing, and have been since birth. I was born to two deaf parents and my sister is hard of hearing as well (Note: Both the terms “deaf” and “hard of hearing” refer to individuals with hearing impairment; those who rely on sign language for communication generally identify as being deaf, whereas hard of hearing refers to those relying primarily on oral speech).

Estimates of the prevalence of hearing impairment in the general population vary dramatically depending on the criteria used. According to the World Health Organization, the prevalence of permanent, congenital hearing loss in the US is roughly 1% . However, approximately 25% of individuals aged 65-75 years and 70-80% of individuals over the age of 75 suffer from age-related hearing loss.

These are hearing aids that I wear | Click the image to go to the manufacturer’s website

I have a severe-to-profound hearing loss and I wear two hearing aids. In case you’re wondering, no, I can’t hear anything without them. Through a lot of effort and support from my family and speech therapists, most people are largely unaware of my hearing impairment, that is, until we find ourselves in a noisy hallway or café and I ask them to repeat themselves (often numerous times). I’ve encountered some unique challenges during my undergraduate studies, but now that I’m in graduate school, the environment has changed. And the stakes are higher.

In retrospect, I’m very lucky to be where I am, and I’m committed to improving the lives of hearing impaired individuals and students.

In order to understand the perspective of what it’s like for someone with hearing loss both inside and outside of the classroom, it’s important to dispel some common misperceptions about coping with hearing impairment. Below are five key strategies requisite to successful communication with hearing impaired individuals (Please note that most of these points assume that the individual uses oral speech rather than sign language).

1) It’s not just about amplification, it’s about clarity.I once emailed a well-known psychologist who produces demonstrative therapy videos for students and clinicians. Her DVDs were not subtitled, and as such I could not benefit from having access to them, so I asked if it was possible to obtain a set with subtitles. The response I received from her staff member (who had PhD and thus was academically endowed) was that they did not provide subtitles, but that I might consider listening through a headset so as to increase the volume level. Similarly, in high school, I asked my French teacher to repeat something, and she responded with “turn up your hearing aid”.

Good hearing ability requires both good sensitivity (i.e., level of volume), as well as good acuity. While hearing aids and other assistive listening devices provide a boost in sensitivity (that is, they make sounds louder), they unfortunately don’t compensate for deficits in acuity (meaning that they don’t make sounds clearer or more resolvable). My research supervisor likens this to taking someone who has myopic vision and increasing the brightness of the room without giving them glasses. Thus, as you can see, amplification is only a partial solution to the problem.

2) We need to see your lips.Because of an inability to rely on auditory input, many hard of hearing and deaf individuals rely heavily on visual speech input (or lip-reading) for speech understanding. We actually all do this, but people who are hard of hearing, like myself, rely on visual speech more than the average person. In fact, you may be surprised to know that many of these individuals can understand you through lip-reading alone! However, it’s important to remember that visual speech is affected by lighting conditions, distance from the speaker, and visual obstructions (like covering your hand with your mouth, which people often do, to be polite while eating). For this reason, it is also considered polite to get the attention of the individual before you start speaking to them. Incidentally, it’s also not a good idea to over-enunciate; we have less experience with exaggerated speech movements, and thus they are often actually more difficult to understand! However, the catch is that everyone’s visual speech looks a bit different, so individuals with accents or less typical speech production movements can be harder to lip-read.

3) Hearing is especially harder when there is background noise
Individuals with hearing loss are significantly more adversely affected by interference from background noise or disruptions. Given the deficits in hearing acuity, it is very difficult for someone who is hard of hearing to separate the target message from the background. Therefore, they have to rely more on context, experience, or informed guesses to understand what’s being said. Which leads to the next point…

4) Speech understanding requires effort
Since those with hearing impairments have to rely on visual information and other sources of information to boost speech understanding, this means that hearing is more effortful in this population. As an analogy, think about trying to hear a conversation in a noisy restaurant or a crowded pub; it’s not as easy as when you’re listening in a quiet room. However, the reality is that most of our conversations (especially outside of the classroom) take place in these environments. In addition, understanding becomes more effortful not just as you increase the background noise, but also as the content of the message becomes more challenging (e.g., think about trying to follow an intense academic discussion in a pub vs. talking about what you ate for dinner last night). Both of these factors draw on your cognitive capacity.

5) Subtitles for Audiovisual Media are Absolutely Necessary
Audiovisual media are largely unsuitable for even someone with mild hearing loss. In the case of voice-over narration or when the camera is facing elsewhere or too far away from the speaker, lip-reading becomes impossible. Even if the camera is focused on the speaker for the entire duration of the clip, the resolution and visual clarity often does not match those of real-life conditions, making lip-reading difficult. This is also complicated by the fact that films or media often have music playing in the background. An analogy I often give is watching a foreign movie in a language for which you aren’t entirely fluent without subtitles. Not very easy or enjoyable is it? Subtitles (or closed captioning) aren’t a luxury for those with hearing impairments; they are a necessity.

In conjunction with the above principles, successful communication with hearing-impaired individuals ultimately relies on sensitivity and patience. You may sometimes forget to employ some of these strategies from time to time, and that’s quite normal. In fact, my friends and colleagues occasionally forget to look at me while speaking, apologetically remarking that they often forget I have a disability. I take this as a great compliment. The suggestion that my disability has faded into the background, I think, is the hallmark of true integration.

Rachel Wayne is a PhD candidate in the Clinical Psychology program at Queen’s University. Her research focuses on understanding ways in which we use environmental cues, context, and lip-reading to support conversational speech, particularly in noisy environments. The goal of this research is to provide a foundational basis for empirically supported rehabilitative programs for hearing-impaired individuals. Rachel can be contacted at 8rw16[at]queensu.ca

Post navigation

Atif completed his Masters and PhD in Epidemiology at Queen’s University, and currently works in health services research in Toronto, Canada as an epidemiologist. While his research examines the health of Canadians, he is also heavily involved in science outreach and communication. You can connect with him on Twitter @DrEpid

3 comments

Love this metaphor!
“My research supervisor likens this to taking someone who has myopic vision and increasing the brightness of the room without giving them glasses”.
Rachel, I hope that your HA’s are equipped with telecoils and that you are finding some opportunities to use them in hearing loops. Hearing loops and telecoils might be like wearing binoculars!